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Law Offices of Scott Glovsky

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OUR OFFICES:
  • Claremont
    • 343 Harvard Avenue
      Claremont, CA 91711Get Directions
    • Call: (909) 296-7700
  • Pasadena
    • 299 N. Euclid Ave.
      Second Floor
      Pasadena, CA 91101
      Get Directions
    • Call: (626) 243-5598

(626) 243-5598

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Los Angeles Prescription Denial Lawyer

Millions of Americans take prescription drugs every day. These prescriptions treat thousands of conditions. Some are even life-saving and can increase the person’s quality of life drastically. The downfall to prescription medications is that some can be quite costly, even with insurance coverage.

Furthermore, your insurance company may decide to deny certain, necessary prescriptions. However, paying out of pocket for some of these much-needed medications can be impossible. A Los Angeles prescription denial lawyer may be the key to getting your insurance company to approve a prescription drug your doctor has ordered. By fully examining the terms of your policy, an insurance denials lawyer can help make sure your insurance carrier is fully honoring their contract with you.

Glovsky Case Result: Fraud & Bad Faith After Insured Needs Medication for High Blood Pressure & Diabetes

Reasons for Prescription Drug Denials

Health insurance companies are notorious for caring more about their financial health than the physical and mental health of the individuals and families they insure. One of the ways they accomplish this goal is by looking for different reasons to deny a claim. When a prescription drug is denied by a health insurance company, it may be for one of several reasons.

Not Enough Evidence to Support Need

An insurance company may deny payment for a prescription, even when it was ordered by a licensed physician. This may be because they believe they do not have enough evidence to support the need for the medication. Getting detailed information in writing explaining the medical need for a prescription drug, either from the physician directly or via the office manager may help.

Additionally, a Los Angeles prescription denial lawyer can help the insured write a letter to their insurance company explaining why this prescription is a medical necessity. It should include the experience of the insured with the medication and how alternative medications or treatment do not produce as positive a result as this particular prescription.

Lacks FDA Approval for Condition

Another defense health insurance companies may use to deny a prescription drug claim is purporting that the medication is not FDA approved for the condition that the doctor has prescribed it for. Providing the insurance company with facts about how the medication has been used to treat this specific condition, such as reliable studies or even letters from other patients who have successfully taken this particular drug for the same condition can also sometimes help. A prescription denial attorney in Los Angeles can help determine what evidence could help reverse the denial.

Prescription Drug Insurance Laws in Los Angeles

Patients have several rights under California laws regarding prescription drug coverage. One of these laws covers step therapy, or the practice of insurance companies to mandate that patients try other similar medications before prescribing the one specifically requested by their doctor.

As per California Health and Safety Code Section 1367.243, a prescription drug plan cannot require an insured individual to try and fail more than two prescription medications prior to allowing them access to the medication that was originally prescribed. The only exception to this law is if there is clinical evidence that supports the patient trying more than two prescriptions before trying a requested medication.

Let a Los Angeles Prescription Denial Attorney Help

Trying to get a prescription medication approved by your health insurance company can be frustrating. You may feel as if you are fighting an uphill battle and may even lose hope. However, a Los Angeles prescription denial lawyer can help.

An experienced attorney knows what it is like to have your insurance company deny a medication that you desperately need. They also know how California insurance laws apply in these circumstances.

Their passion for helping insured individuals combined with their knowledge of insurance law put them in a position to be able to effectively fight for you. Call today to learn more.

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Testimonial

“As a young lawyer, I am appreciative of great lawyers like yourself, who are willing to take the time to pass your knowledge and wisdom onto others.  I just finished your podcast with Greg Reeves.  I grew up with Greg’s niece, and his brother built my childhood home.  I had no idea how great of a lawyer he was until recently.  I started following him on Instagram after I graduated law school, and he is the reason I was led to your podcast a few months ago and to Gerry Spence’s book “Win Your Case”.

I hope to be able to attend the Ranch and effectively incorporate the techniques you discuss in one of the coming years. I hope you are able to keep the podcast going, and I look forward to each episode.

Thank you for sharing your gift with us.”

- J.F.B

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343 Harvard Avenue
Claremont, CA 91711
(626) 243-5598
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Copyright © 2021 Law Offices of Scott Glovsky
Disclaimer Privacy Policy

The Law Offices of Scott Glovsky is a Professional Corporation. Information on this website is not intended as and is not legal advice. The information does not establish an attorney-client relationship. Case results are not a prediction or guarantee of potential case outcomes. This website is an attorney advertisement.

  • Home
  • About
    ▼
    • About Our Firm
    • Attorneys
    • How Our Firm Has Changed Lives
    • How We Operate
  • Health Insurance Denials
    ▼
    • Insurance Bad Faith
    • Health Insurance Claim Denials
    • Insurance Companies We Fight
      ▼
      • Aetna Denial
      • Anthem Blue Cross Denial
      • Blue Shield of California Denial
      • Health Net Denial
      • Kaiser Permanente Denial
      • OSCAR Health Plan Denial
      • Magellan Healthcare Denial
      • Molina Healthcare Denial
      • Regal Medical Group Denial
      • UnitedHealthcare Denial
    • Medical Necessity Denials
    • Experimental/Investigational Denials
    • Out-of-Network Denials
  • Personal Injury
    ▼
    • Accidents
      ▼
      • Bicycle Accidents
      • Car Accidents
      • Motorcycle Accidents
      • Truck Accidents
    • Traumatic Brain Injury
    • Catastrophic Injury
    • Burn Injury
    • Wrongful Death
    • Premise Liability
    • Slip & Fall
    • Product Liability
    • Nursing Home Abuse
    • Elder Abuse
  • Sexual Abuse
    ▼
    • Types of Sexual Abuse
    • Child Sexual Abuse
    • Campus Abuse
    • Special Needs Abuse
    • Abuse at School
    • Abuse at Camp
    • Abuse by a Clergy Member
    • Abuse by Athletic Coaches
  • Business Issues
    ▼
    • Employment & Business Issues
    • Broker & Agent Negligence
    • Business Contingency Litigation
    • Unfair Business Practices
    • Workplace Harassment
    • Wrongful Termination
    • Whistleblower
      ▼
      • Qui-Tam
  • Results
    ▼
    • Testimonials
    • Case Results
  • In The Media
  • Resources
    ▼
    • Frequently Asked Questions
    • Trial Lawyer Talk Podcast
    • Blog
    • Guides
    • Sign Up for Our Mailing List
    • Download Our eBook
    • Fight Health Insurance Denials Book
    • Power of Resilience Scholarship
  • Contact